ARIZONA FORM
342
2012
Credit for Renewable Energy Industry
For the calendar year 2012 or
M M D D Y Y Y Y
M M D D Y Y Y Y
fi scal year beginning
and ending
.
Attach this completed form and the Certifi cation of Qualifi cation from the Arizona Commerce Authority to your return.
Name(s) as shown on Form 140, 140PY, 140NR, 140X, 120, 120A, 120S, 120X, or 165
Social security or employer identifi cation number
Part I
Listing of Post-Approved Renewable Energy Operations and Apportioned Credit Amount
List renewable energy operations for which you are entitled to claim a credit during this taxable year.
If you have more than two operations, attach additional schedules. See instructions.
(a)
(b)
Arizona Commerce Authority Post-Approval Information
(a)1
(a)2
(a)3
Post-Approval
Allocation Year
Post-Approval Date
Number
Apportioned Credit Amount
YYYY
YYYY
MM DD YYYY
00
1
YYYY
MM DD YYYY
00
2
Aggregate total from all additional schedules .....................................................................
00
3
00
Total - add lines 1 through 3 ...............................................................................................
4
Part II
Credit Recapture
5 Date on which the Certifi cation of the business as a renewable energy industry was terminated or revoked ...........
5
MM DD YYYY
MM DD YYYY
6 Total recapture of apportioned credit for renewable energy industry. Full amount of credits previously claimed or
passed through to S corporation shareholders or partners of a partnership.
Enter the amounts from Part I, column (b) on Form 342 for the tax years prior to the date on line 5.
00
If more than one Certifi cation has been terminated or revoked, enter the aggregate amount ...................................
6
Part III S Corporation Credit Election and Shareholder’s Share of Credit and Credit Recapture
MM DD YYYY
7 The S corporation has made an irrevocable election for the taxable year ending
to:
(CHECK ONLY ONE BOX)
Claim the credit for renewable energy industry as shown on Part I, line 4 (for the taxable year mentioned above);
OR
Pass the credit for renewable energy industry as shown on Part I, line 4 (for the taxable year mentioned above) through to its shareholders.
Signature
Title
Date
If passing the credit through to the shareholders, complete lines 8 through 10 separately for each shareholder.
If passing credit recapture through to the shareholders, complete line 11 separately for each shareholder.
Furnish each shareholder with a copy of the Certifi cation from Commerce and pages 1 and 2 of Form 342.
8 Name of shareholder
9 Shareholder’s TIN
00
10 Shareholder’s share of the apportioned credit for renewable energy industry from Part I, line 4 .................................... 10
00
11 Shareholder’s share of the credit recapture from Part II, line 6 ........................................................................................ 11
ADOR 11130 (12)